肝动脉灌注自体树突状细胞-细胞因子诱导的杀伤细胞联合肝动脉化疗栓塞术治疗原发性肝癌的疗效  

Efficacy of transcatheter arterial chemoembolization cells treated with hepatic arterial infusion of autologous dendritic cells-cytokine induced killer cells in the treatment of primary hepatic carcinoma

作　　者：李庆[1] 周定中[1] 龙文兴[1] 肖华平[1] 李涛[1] 

机构地区：[1]湘南学院附属医院,郴州423000

出　　处：《中国肿瘤临床与康复》2016年第5期526-530,共5页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：湖南省卫生厅科研课题(B2012-075);湖南省教育厅科研项目(12C0819)

摘　　要：目的探讨肝动脉灌注自体树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)联合肝动脉化疗栓塞术(TACE)治疗原发性肝癌的临床价值。方法选取2012年5月至2014年6月间收治的80例临床确诊为HCC的住院患者,按随机数字表法分为动脉联合组和静脉联合组,每组各40例。动脉联合组患者给予肝动脉灌注自体DC-CIK细胞联合TACE治疗,静脉联合组患者给予静脉回输自体DC-CIK细胞联合TACE治疗,比较两组患者治疗前后外周血CD3^+、CD4^+、CD8^+T细胞亚群变化、肿瘤大小、甲胎蛋白(AFP)变化及临床卡氏体能状态(KPS)。结果动脉联合组和静脉联合组患者肿瘤体积缩小率总有效率分别为92.5%和57.5%;AFP转阴率分别为85.0%和45.0%;KPS评分生活质量稳定改善率分别为92.5%和65.0%,动脉联合组患者外周血CD3^+、CD4^+T细胞亚群较静脉联合组明显升高,动脉联合组CD8^+T细胞比例下降明显,静脉组CD8^+T细胞比例下降不明显。与静脉联合组治疗相比,动脉联合组患者的肿瘤大小、AFP变化及临床KPS评价、外周血CD3^+、CD4^+、CD8^+T细胞亚群变化差异均有统计学意义(P<0.05)。结论动脉联合TACE治疗HCC可明显提高肿瘤的疗效,在减少肿瘤残留、改善机体免疫功能受损、提高肿瘤的控制率方面均具有积极的作用。Objective To explore the efficacy of transcatheter arterial chemoembolization（ TACE） cells treated with hepatic arterial infusion of autologous dendritic cells（ DCs）-cytokine induced killer（ CIK）cells in the treatment of primary hepatic carcinoma. Methods From May 2012 to June 2014 in Xiangnan College Affiliated Hospital,80 primary liver cancer patients were enrolled in the study and randomly divided into artery combined group and and intravenous combined group,40 cases in each group. The patients in the artery combined group accepted autologous DC-CIK cells combined with TACE treatment by hepatic artery infusion and those in the intravenous combined group accepted autologous DC-CIK cells combined with TACE therapy by venous reinfusion. Before and after treatment,the peripheral blood T cell subsets CD3^＋,CD4^＋,CD8^＋phenotypic changes,the change of tumor size,alpha fetoprotein（ AFP） value changes and Karnofsky performance status（ KPS） score changes were compared between the two groups. Results The tumor volume reduction rate,the AFP transferring into negative rates and KPS improvement rates of the artery combined group were 92. 5%,85. 0%,92. 5%,and those in the intravenous combined group were57. 5%,45. 0% and 65. 0%,with significant difference（ P〈0. 05）. Compared with intravenous combined group,peripheral blood T cell subsets CD3^＋,CD4^＋in the artery combined group increased more obviously,and CD8^＋decreased significantly,with significant difference（ P〈0. 05）. Tumor size,AFP,KPS changes and clinical evaluation of peripheral blood T cell subsets CD3^＋,CD4^＋,CD8^＋variation between the two groups showed significant difference（ P〈0. 05）. Conclusions Arterial joint TACE treatment in primary liver cancer can obviously improve the curative effect of tumor,reduce tumor residue,improve the impaired immune function and improve the tumor control rate.

关 键 词：肝肿瘤 肝动脉化疗栓塞术 树突状细胞-细胞因子诱导的杀伤细胞 外周T细胞亚群 

分 类 号：R735.7[医药卫生—肿瘤]